Laparoscopic Cholecystectomy Post-op Instructions

Laparoscopic Cholecystectomy Post-op Instructions

Diet

Start with clear liquids today to prevent nausea, vomiting and constipation, (soup, Jell-O, juices, popsicles, and carbonated beverages.) then advance to a regular low fat diet.

Eat smaller meals more often instead of fewer larger meals. You can eat a normal diet, but avoid eating fatty food for about one (1) month. Fatty foods include hamburgers,

whole milk, cheese and many snack foods. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast and yogurt. Drink plenty of fluids (unless your doctor tells you not to). If you have diarrhea, try avoiding spicy foods, dairy products, fatty foods and alcohol. If the diarrhea continues for more than 2 weeks, talk to your doctor. Eat lots of whole grains, fruits, green leafy vegetables. Avoid foods that cause constipation such as dairy products, red meat, processed foods such as pizza, frozen dinners, pasta, and sugar products such as cakes, pies, pastries, doughnuts and drinks containing caffeine.

Medication

Take pain medications as prescribed by your doctor. Take your pain medication with crackers or toast. ______________________________________________________________

Take stool softener as prescribed by your doctor. _______________________________ Take antibiotics as ordered if prescribed by your doctor _______________________________

Activity

Rest for the next 24 hours. No strenuous activity for two weeks. No heavy lifting for two (2) weeks.

Dressing

T here will be 4 to 5 small incisions in the abdominal area. Your incisions will be closed with skin clips or sutures as determined by your surgeon. Dressings will cover your incisions.

Keep your dressings clean and dry for 48 hours. You may remove your outer dressing in 48 hours. After you have removed your dressing, you may cover your

incisions with Band-Aids or leave them open to air, which ever is more comfortable for you. You may shower after you remove your dressing. If you have steri strips (thin strips of white tape), leave them in place until they fall off on their own in about 10

days. If you have skin glue, a T opical Skin Adhesive, this will naturally slough off your skin in 5-10 days. Do not rub,

scratch, or pick at skin glue. Do not apply any medications on any products to wound while skin glue is in place. You may shower only, after 24 hrs.

Laparoscopic Cholecystectomy Post-op Instructions

Bathing

You may shower tomorrow if you have skin glue or after 48 hours when dressings are removed. No bathing, immersion or swimming for at least two (2) weeks.

What to Expect

It is common to experience: Right shoulder discomfort, chest tightness, bilateral shoulder discomfort for 24 to 48 hours after surgery, gradually this will go away. It is caused by carbon dioxide used to inflate your abdomen during the procedure. Carbon dioxide is a gas, and like all gases, travels upwards, settling on your chest and shoulders.

Soreness in the abdominal area similar to an ache you would feel after starting a new exercise program involving your abdominal muscles. This ache will gradually go away within a few days.

Your abdomen may be distended for a few days after surgery. There may be a large black or blue area (bruise), on your abdomen to your hip. This may appear within the first

week after surgery. It is caused by blood pooling under the skin from your surgery. Your body will reabsorb this blood over time. T he bruise will turn yellow and disappear in time. You may feel sleepy, rest for the first 24 hours. You may have some nausea or vomiting the day of surgery, but this should not persist beyond the day AFT ER surgery. You may have a sore throat, if you received general anesthesia It may take a few days before you have a bowel movement. Bowel irregularity is expected with pain medication. Take stool softener as ordered for constipation. You may also experience diarrhea, especially if eating foods high in fat. This should gradually resolve, allowing your diet to return to normal.

Sterile Suction Drain (JP Drain)

If your gallbladder was infected, your surgeon will insert a tube in the incision to drain fluid out of the surgical site. The tube will have a bulb-like devise at the end of the tube to collect the fluid. When you return for a postoperative visit your surgeon will remove the drain.

How to Empty the Sterile Suction Drain:

Before and after you empty the drain reservoir wash your hands well with soap and running water. Pay special attention to rubbing your fingers, fingernails and the backs of your hands. Hand washing is an important step to help prevent infection.

Empty your drain reservoir when you get up in the morning and before you go to bed at night. Pour the contents of the reservoir into the measuring cup, record the amount of drainage. Bring this record to

your next visit with your surgeon. Squeeze the sides of the reservoir to remove all air. Reinsert the cap. T he drain works properly only when the

sides are flattened and a light suction is created. Pin the reservoirs to your clothing to prevent pulling on the tubing.

Laparoscopic Cholecystectomy Post-op Instructions

Miscellaneous

No alcohol or driving for 24 hours after surgery or while taking pain medicine. Do not make any personal or business decisions for 24 hours. You should have a responsible adult with you for the rest of the day and night.

Possible Problems

Call your surgeon if:

Unable to drink liquids in the morning because of nausea. Unable to urinate eight hours after your surgery. Your temperature is greater than 101.5 degrees F. You notice excessive bleeding or unexpected drainage from the wound site. You notice extreme redness or warmth around your incision sites. You notice wound edges open or separate. Your pain is not relieved by pain medication.

Call your surgeon if you have any of the following symptoms:

Severe right upper abdominal pain

Right upper abdominal pain increasing over time

Right upper abdominal pain with or after eating. Yellow discoloration of skin or eyes (jaundice)

Temperature > 101.5 degrees F

When it Might Occur Possible Cause

Within 48 hours

Retained common bile duct stone, or post-op pain from musc le injury

Hours to days after the proc edure

Delayed bleeding or bile leak

May occur weeks later Gallstones in common duct

Within two weeks

Infection within the abdomen or in one of the incisions

Laparoscopic Cholecystectomy Post-op Instructions

Telephone numbers to call with Problems or Questions

Surgery Clinic: Department 286 Mon ? Fri, 8:30 a.m. to 5 p.m. (408) 851-2000

Medical Offices Call Center Mon ? Fri, After Business Hours, Weekends and Holidays (408) 554-9800

Emergency Department Open 24 hours (408) 851-5300

Anesthesia Service Line Open 24 hours; your call will be returned within one business day. (408) 851-6020

Follow-up Appointment

Name: Date: Return to Work:

Place: Time: M edical Provider:

? 2011, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. ######### (Revised 10-11) RL 7.5

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